Leaving stitch and stent in 2 weeks after inverted nipple surgery. Is it ok to leave it in that long?

Question

I just had inverted nipple surgery a day ago and they placed a stent over my nipple connected to a stitch to keep it erect, which they said is normally held in place for a week. However, I will be out of town the following week and have arranged to come in in 2 weeks. They said this is totally fine and they will remove the stitch and stent in 2 weeks, I'm just concerned if it's okay to leave that one stitch in that long?

Jed H. Horowitz, MD, FACS · Answer

The Naked Surgeon:

Plastic Surgery, The Naked Truth about Nipple Correction

To begin with, many women refer to the part of the breast with the Areola and Nipple as “The Nipple”.  Let’s discuss anatomy for a moment.  The nipple is the part that generally protrudes out from the center of what is actually the Areola.  The Areola is the larger pigmented, generally round area usually centered on the breast.  The pigment and shape can vary depending on ethnicity, genetics, pregnancy and so forth. The areola can be extremely pale and the edge hard to distinguish from the rest of the breast skin. On the other hand, it can be large, very dark and even elevated from the skin as a small “cap”.  There may also be small bumps on the areola called Montgomery tubercles.  These can enlarge with pregnancy, breast feeding or periods.

There are a variety of surgical and non-surgical treatments for each of these anatomic breast parts.  Nipple correction is often requested for correction of inversion, repair from piercings or traumatic injuries, reduction of an overly wide or projecting nipple or enlargement for nipples that are not projecting enough.

Areola correction is generally requested for areolas that are asymmetric, too large, or too projecting. Overly projecting areolas are commonly seen in patients who have a tuberous or tubular breast condition.

Most of these procedures can be done in the office under local anesthesia with minimal or no down time and quick healing. All of these procedures may interfere with breast feeding, or change and diminish sensation, so this must be considered by the patient before proceeding with a procedure.

Nipple Reduction

Correction of protruding nipples and correction of inverted nipples (ones that actually are “retracted “into the areola are the two most commonly requested procedures.  Of interest is that Nipple Correction is frequently request by men as well. Overly projecting nipples may be too visible even with clothing in place. For men these may be too visible even in a t-shirt or tank top.  Obviously, these can be covered with band-aides or nipple covers or “shields” easily available in many stores and even on-line.

It is also possible that the nipple is too wide in diameter, or even a combination of too wide and too protruding can exist. We have seen patients for Nipple Correction in Newport Beach, and Orange County for more than twenty years and it has been a consistently requested procedure during that time.   Nipple Augmentation particularly with injectable products such as Juvéderm seem to more commonly follow social and fashion trends. Injectable Nipple Augmentation is a very simple and quick treatment that can be reversed if the patient finds that it doesn’t achieve their desired goal.

Nipple Augmentation

Surgical Nipple Reduction

This is a very simple outpatient treatment that can be done in the office with local anesthetic. It is very quick and heals in a few days with little down time from daily activities. Dissolving sutures are used and the aftercare is quite simple. Pain is generally managed with Tylenol or Advil.  Non-surgical nipple reduction options are discussed above.

These treatments can be found on our YouTube link   channel or Pacific Center for Plastic Surgery web site add link

Inverted Nipple Correction

This is a surprising common problem for women, seen in as many as 2% of adult females. This can be bilateral or may occur only on one side. This interferes with the ability to breast feed. It is also a source of embarrassment for many post-adolescent women especially with current trends in social media allowing the viewing of other women to be readily accessible.

For some women, the nipple can be pushed out or may come out naturally with cold as the Areola contracts. This can occur with adolescent breast development, after breast feeding, trauma or a growth in the breast tissue.

Surgical Correction of inverted nipples is also a simple operation for most women that can be done in the office as a brief procedure with local anesthesia.  It requires very small incisions that generally become invisible. Although the breast ducts are frequently affected by the surgery, we use techniques of duct sparing surgery that provides a greater chance to preserve some duct function and sensation. It is common to perform inverted nipple surgery at the same time as another breast operation such as breast augmentation, mastopexy, breast reduction or breast revision surgery.

Again, when deciding to have the surgery, our patients must accept the possibility that the ducts will not work and allow breast feeding. They will also have a high risk of diminished sensation.  That being said, the majority of our patients are overwhelmingly happy to have the correction of their nipples.

How long does the surgery take to perform?

Inverted nipple correction is a short procedure which usually takes about one hour for both sides as an outpatient surgery.

What type of anesthesia is used to correct my inverted nipples?

Most often, the operation will be done with topical and local anesthesia.  We offer Nitrous Oxide (laughing gas) as well.  Patients may choose twilight or general anesthesia, but this is usually not necessary.

Non-surgical inverted nipple correction

This is  best accomplished with a device such as the Phillips AVENT Niplette. This is a device, shaped like a thimble that attaches to the nipple with a small amount of suction, pulling the nipple out of its inverted position.  We often recommend that patients use the Niplette before and after surgery to obtain the best result.

How much does inverted nipple correction cost in Newport Beach, Orange County , California

The average cost for this surgery of both sides of the breasts, including operation room, supplies and anesthesia is about $3-6000 dollars by most doctors, however, because of our experience, we can usually offer this to our patients in our office surgery center for less than $3000.00.

Daniel Barrett, MD · Answer

Dear ta18420,every plastic surgeon has his own postoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Tom J. Pousti, MD · Answer

Procedures and protocols will vary from one practice to another. Best to clarify with your plastic surgeon; it is okay to communicate your concerns/questions directly with him/her. Otherwise, online consultants can only speculate…

Lawrence N. Gray, MD (retired) · Answer

There are many different ways to correct an inverted nipple. I do not see a problem leaving a stitch and stent for 2 weeks. I personally do not use that technique. Normally, I would see a patient for suture removal within a week. Your surgeon may have used glue or absorbable sutures.

Leaving stitch and stent in 2 weeks after inverted nipple surgery. Is it ok to leave it in that long?

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